Understanding Different Types of Depression

Whenever I talk to a person struggling with depression, I always get the feeling of a dull, drab blanket that’s been pulled over their entire life. It’s easy for anyone involved in depression – both practitioners and sufferers alike – to feel like depression is a mystery wrapped in an enigma, impervious to investigation.

But the more I work with it, the more I believe it is possible to decode depression.

I believe every person suffering from depression has the power to unravel it, to slowly but surely drag it out of its own dull amorphousness, like pulling a ring out of glue, to see it more clearly.

To start, however, we must first have a basic understanding of the different types of depression.

As I said in my last post, depression has myriad causes generally. But for each singular depression, there are unique and particular causes that can be discovered and understood. Each one of us walking around with depression has our “own” depression, as surely as we each have our own fingerprint or our own phone number.

But getting to specific causal factors can be tricky. The problem with the depressed mind is that it cloaks itself in dark thoughts, so it can be hard for insights to emerge as we would like them to: in the bright, clean light of analytical thinking. Let’s face it, for most of us, our analytical mind is shit when we’re depressed.

So to start, it helps to get a sense of what type of depression you have, broadly speaking. To get a sense of where your depression lives in you.

What do I mean by this? After healing multiple depressions of my own, working with private clients with depression and interviewing many holistic mental health professionals, I’ve concluded there are three basic types of depression.

These three types revolve around our biology, our emotions or our meaning. I find it helpful to think about these things as actual parts of you – different parts of your being.

I call them your biological body, your emotional body and your meaning body.

Let’s look at each one in detail.

Your Biological Body

When I refer to biological depression, I’m not talking about depression as a “serotonin deficiency,” a characterization hopelessly incomplete and myopic, as I described in my last post.

To understand what biological depression actually is, we need to look at it through the lens of functional medicine. Mark Hyman, MD, the director of the Cleveland Clinic Center for Functional Medicine, and one of America’s most prominent functional physicians, has said:

“Functional Medicine seeks to identify the root causes of symptoms to correct imbalances and find long-lasting healing that supports the body, mind and spirit as a whole and it’s completely personalized.”

Functional medicine looks at systems — the big systems of the body, like digestion, hormones and sugar metabolism. It views chronic disease as a disruption in these big systems, which can be brought back into proper balance and right functioning by a combination of food choices, lifestyle practices and stress management – sometimes with targeted supplementation or hormone therapy thrown into the mix as well.

Take a look at this infographic from the Institute For Functional Medicine:  

It shows how a condition like depression can have multiple causes emanating from different imbalances within the physical body. On the flip side, a single biological phenomenon like inflammation can have multiple disease manifestations, depression being only one of them.

A functional physician usually starts with a 60-90 minute intake session where they listen to everything going on with you – both physical and emotional. They will likely order some blood tests to get a snapshot of what’s happening within the body’s big systems: hormones, digestion, stress, etc. This detective work is helpful to start pinpointing causal agents of depression within your biological body.

If you’d like to find a functional physician, the Institute of Functional Medicine has a large referral network; go to their website and plug in your zip code.

Your Emotional Body

As I’ve interviewed psychotherapists about depression over the years, one particular idea has emerged over and over again. When depression is the result of a certain kind of childhood wounding or trauma, at the heart of that depression lies a basic feeling of helplessness.

What lies at the core of that helplessness? The feeling that we are not safe or not loved, and there’s nothing we can do to change that.

These core beliefs of helplessness, forged when we are little, might sound like this:

The world is a dangerous place.
You’re not good enough.
You’re basically disappointing.
Everyone is sad.
It’s your fault.
You can’t have nice things.
You’re not worthy of love.

The list goes on, a dazzling array of permutations around the same two sensations of unworthiness and fear.

When we’re little, sometimes these beliefs are taught to us quite literally by other people; in other cases we infer them incorrectly through the sadness, fear or depression of a primary caregiver.

In any event, once these beliefs get lodged into the deepest part of our consciousness, they lead to a negative feedback loop of hopeless thoughts and action paralysis that keep us sad and stuck in later life; this is what we call depression.

When depression lives in the Emotional Body, it’s usually most effective to use psychotherapy to help unravel and release these old dysfunctional beliefs. However, people have found other paths to healing as well, such as spiritual practice, yoga, or group encounter work. Each one in their own way can dislodge fear and help us affirm our own innate safety and worthiness.

I began to really understand the significance of the emotional body in my mid-30s, when I was doing some deeply emotional work in therapy. I was exploring a certain feeling of being hopelessly alone from my childhood. In tracking down its origin, I began speaking and assuming the posture of the little girl I once was. It was as if I accessed the actual “operating system” from when I was first programmed with this belief.

What struck me as I communed with this raw vulnerability was a sense that my very survival was at stake. Not metaphorically, but literally.

The sense that we can’t get what we need for our survival is what lies at the heart of depression’s hopeless, helpless feeling.

As we come to terms with these old beliefs through our adult selves, we can compassionately release them, knowing we are now safe. We can affirm we’re worthy of love.

Healing these kinds of old wounds does not occur overnight, but with patience and courage, it’s absolutely possible.

Your Meaning Body

The core of this type of depression is you feel stuck, you have no idea how to get un-stuck, and depression becomes an almost poetic reflection of this.

The stuck feeling could really be anything: Stuck between your parents’ vision for you and your own; stuck between old, limiting beliefs and what you sense is actually possible; stuck between what society tells you is proper while yearning to chart your own eccentric course.

The truth is, the stuck feeling hints at something much more profound than simply whether you like your job or not… it bumps up against the question of whether or not you feel your life has meaning.

What is meaning and why is it important?

I believe that meaning is elemental and irreducible, like joy or beauty. Without defining it explicitly, we can still get a good sense of what it is by observing how it (or the lack of it) makes us feel.

Meaning is the fuel that propels us forward. When we spend years creating a life devoid of meaning, we wake up one day to realize our life contains no motivational fuel. It feels like it doesn’t matter whether we get out of bed, whether we go to work or whether we buy the groceries; we have the oddest sense that it literally makes no difference whether we do these things or not.

You don’t need to climb to the top of a mountain peak and commune with an enlightened master to grasp meaning or to achieve it.

The funny thing about meaning is it’s often much more mundane than that. It can be found in those little things you’re interested in, those things you think about and noodle on, not because you have to, but because you like to.

Meaningfulness is unique to each of us. For some people, creating a homemade cookie company feels meaningful; for others, making sure people in developing countries have clean water does, and for others, attending a local school board meeting feels hugely meaningful.

I have a simple template for how to shift into a more meaningful life. It starts with those little things that keep us interested, or that we find ourselves paying attention to for no real reason other than we like to. When we allow those interests to express themselves through connections with other people, that’s when a certain basic vitality in us begins to wake up. Written as an equation, it looks like this:

Interests + Connecting With Others = Meaning

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So now that we know what the three big types of depression are, how do we know which one we’re experiencing? Is it possible to have a combination of depressions?

I have found there are certain feeling-states with clear energetic signatures that clue us in as to which type of depression we’re experiencing. I’ll describe them in detail in my next post.

In the meantime, I would love to share my free Daily Survival Guide for Depression Ebook. Leave me a comment below and let me know what you think.